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The cycle helmet debate continues….

In a recent Croakey post, public health researcher Professor Chris Rissel reported on new research which found that one in five adults say they would cycle more if they didn’t have to wear a bicycle helmet.

Tim Churches, a Sydney-based epidemiologist with a personal interest in active transport and urban re-design who has previously critiqued work by Rissel, has had a close look at the study, and disagrees with some of its methodology and conclusions.

Rather than arguing for the end of mandated cycle helmet wearing, Churches says it would be better for Australian governments and to focus on strategies which have been proven to work in Europe, such as providing separated cycle lanes on busy roads, reducing  speed limits on residential and minor roads, and reforming road rules and accident liability laws to make motor vehicle drivers more responsible for cyclist and pedestrian safety.

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Let’s focus on proven interventions to promote cycling

Tim Churches writes:

In a recent Croakey article titled, More people would cycle if helmets were not compulsory: new study, Professor Chris Rissel reports on the results of a population-based survey which he and Dr Li Ming Wen commissioned into attitudes to compulsory cycling helmet laws amongst Sydney residents.

In the Croakey article, Professor Rissel makes the following claim, based on the study survey results:

“While a hypothetical situation, if only half or a quarter of the one in five respondents who said they would cycle more if they did not have to wear a helmet did ride more, Sydney targets for increasing cycling would be achieved by repealing mandatory bicycle helmet legislation. This increase in cycling would result without having to spend millions of dollars on new cycling infrastructure.”

He makes similar claims in an article in “The Conversation” on the same study, titled “Make helmets optional to double the number of cyclists in Australia”.

These are fairly startling claims which warrant careful examination, particularly when they are presented as offering government authorities the opportunity to meet cycling participation targets without, as Professor Rissel puts it, “having to spend millions of dollars on new cycling infrastructure”.

The cycling participation targets referred to are discussed in the full paper on the study, published in the December 2011 issue of the Health Promotion Journal of Australia. The primary target is contained in the Australian National Cycling Strategy 2011-2016, which calls for a doubling of the number of people cycling by 2016. It proposes three measures of cycling participation: the proportion of the population who have cycled at some time in the last week, in the last month, and in the last year.

The other target discussed is given in the 2010 NSW State Plan, which called for an increase to 5% in the cycling mode-share for all trips made at the local and district level in the Greater Sydney region (from the current Sydney cycling mode-share of about 1.2%). This target has since been superseded in the NSW 2021 plan by a more modest target of a doubling of local trip cycling mode-share in Sydney by 2021.

Professor Rissel provides the following justification for his claims (he gives a similar justification in his “The Conversation” article; text in square brackets has been added to provide context):

“There are about 3.5 million people in Sydney aged 16 years and older. Conservatively 60% haven’t ridden a bike in the past year – leaving 2,100,000. With 19% of people not having ridden [in] the past year saying they would ride more [if they were not compelled to wear a helmet], this represents 399,000 potential riders [if the mandatory helmet requirement were removed].”

So far, so good: the 60% not having ridden in the last year is derived from the study survey results, and this figure is comparable with that found in the much larger 2011 Australian Cycling Participation survey, and the 19% figure is similarly based on the Wen and Rissel survey.

Rissel advises in “The Conversation” article that it is reasonable to “…halve the number of people saying they’d ride but don’t (even the best intentions aren’t always followed through)…”.

In the full paper, as in his Croakey article, he suggests a good-intentions to actual-behavioural-change correction factor of between one-quarter and one-half. Therefore, based on their survey results and Rissel’s own advice, a reasonable estimate of the hypothetical increase in the at-least-once-in-the-last-year adult cyclist numbers in Sydney, if the mandatory helmet road rule were to be removed, would be between 100,000 and 200,000, with an upper bound of about 400,000. Thus the estimate of the total number of at-least-once-in-the-last-year adult cyclists in Sydney would be about 200,000 new (presumably unhelmeted) cyclists plus about 1.2 million existing at-least-once-a-year adult cyclists (based on the Wen and Rissel survey estimate that 34% of the adult Sydney population of about 3.5 million reporting had cycled in the previous year), giving a hypothetical total of 1.4 million cyclists.

The correct baseline with which to compare this hypothetical no-mandatory-helmets estimate is, of course, the estimate of current at-least-once-in-the-last-year adult cyclists from the same survey: about 1.2 million.

Thus, based on their survey results, the hypothetical increase in the at-least-once-in-the-last-year cycling participation in Sydney adults, if the compulsory helmet requirement were to be removed, would be an increase from 1.2 million to 1.4 million people, which is a 17% change.

This is a great deal less than the 100% increase required by the 2016 cycling participation target.

However, in justifying his claims for meeting cycling targets, Professor Rissel inexplicably does not use the estimate of current adult cycling participation in Sydney from his own survey. Instead, he derives a baseline cycling participation number for use in his calculations as follows:

“In Sydney, the [2006] Census tells us that about 10,000 people rode to work on Census day.  We know that this is an under-estimate of cycling levels, but even if we multiply this by a factor of 10 this 100,000 Sydney cyclists are still a quarter of the potential new cyclists.”

In his “The Conversation” article, he justifies his claims thus:

“Compare this figure [the hypothetical 200,000 additional cyclists if helmets were optional] to the 10,000 people who ride to work on Ride to Work Day. Even if you multiply this group by ten to include the 10% of the population who occasionally ride, and then halve the number of people saying they’d ride but don’t (even best intentions aren’t always followed through), this would still double the number of people currently cycling in Sydney.”

To use these figures, based on the 10,000 people who rode to work on Census day in August 2006 (or the apparently identical number of people who commuted by bicycle on Ride to Work Day), multiplied by an arbitrary and unreferenced factor of 10, as an estimate of current at-least-once-in-the-last-year cycling participation is just not valid, and cannot possibly be justified when a far more direct and recent estimate of current at-least-once-in-the-last-year cycling participation is available from the authors’ very own study survey.

This objection to Professor Rissel’s justification for his claims is not just an arcane quibble: his claims are based on a hypothetical before-and-after intervention study, where the intervention is the removal of the mandatory bike helmet requirement and the outcome is the predicted change in cycling participation by Sydney adults, informed by the findings of the authors’ research survey.

A basic epidemiological principle of any before-and-after intervention study, even one conducted as a thought experiment such as this, is that the method used to measure or estimate the outcome (cycling participation in this case) must be the same both before and after the intervention – otherwise it would be unclear whether any apparent change were due to the intervention or to differences in the measurement or estimation method.

It is not scientifically acceptable for Professor Rissel to substitute a “before” estimate derived in a completely different (and questionable) manner in his calculations, particularly when a perfectly valid “before” estimate is available in his own survey results.

Other criticisms of the Rissel and Wen study by Dr Alan Davies can be found on his Melbourne Urbanist blog.

Thus, in short, the claim made by Professor Rissel that the removal of the mandatory helmet road rule would result in the 2016 cycling participation targets being met is not supported by the results of his own study.

Now, it could be argued that, of the people who have not cycled in the last year and who indicated that they would cycle more often if the mandatory helmet rule were removed, a substantial proportion might become regular cyclists, perhaps riding even once a month or more.

However, even if we assume that all of the estimated 200,000 people who might hypothetically increase their cycling if they didn’t have to wear helmets took up cycling at least once a month, then the increase in the at-least-in-the-last-month cycling participation rate would still be only 32%.

Of course, such an assumption is unrealistic, and the increase in at-least-once-a-month cyclists would most likely to be substantially less. In other words, no matter how the hypothetical increase in adult cycling participation is estimated, the claim by Professor Rissel that removing the mandatory helmet requirement would result in cycling participation targets being met is just not supported by his own data.

In order to substantially increase cycling participation and mode-share, and to meet agreed targets, Australian governments and authorities need to focus on strategies which have been proven to work in Europe.

These include provision of separated cycle lanes on busy roads, the reduction of speed limits on residential and minor roads, and reform of road rules and accident liability laws to make motor vehicle drivers more responsible for the safety of vulnerable road users such as cyclists and pedestrians.

Some of these measures require capital investment, although the level of funding required is tiny when compared to the cost of major road infrastructure projects for motor vehicles.

Others, such as lowering residential street speed limits, may save money due to lower accident and injury costs, and may help reclaim our often deserted neighbourhood streets for all forms of active transport, not just cycling.

Rescinding the two-decade-old regulations that require helmets be worn when riding on the road is not a viable alternative to such real action, if even our very modest cycling targets are to be met.

 

 

 

 

 

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  • 1
    Daryl Sadgrove
    Posted December 19, 2011 at 7:01 pm | Permalink

    I find this discussion fascinating. My view is that rather than having a ‘tit for tat’ argument about experimental design, we should remind ourselves that we are not the only country with cyclists, or have looked at cycling safety and participation – we don’t always need Australian research to resolve these types of issues. It amazes me is that for a country which is renowned for having such a ‘laid back’ attitude, we seem to be completely obsessed with safety and have become incredibly risk averse. The fact that NZ and Aus are the only two countries in the world that have seen the need to legislate helmet wearing for cyclists seems at odds with the experience of the rest of the cycling world. Do we have more injuries from cycling? Do we have more dangerous roads? Do we not have enough cycling infrastructure? I have cycled in many countries around the world, those with lots of cycling infrastructure and those with little, the argument that Australia needs helmets because of these arguments is simply not true. We have significantly less injuries from cycling than any other country in the world. Our roads are some of the safest in the world by any standard, yet our perception is that our roads, and that cycling, is extremely dangerous. Studies show that australians perceive that we lack cycling infrastructure, yet comparably we have more separated cycleways and shared cycleways than almost any city in the world. I see the point in wearing a helmet in some circumstances, but I also don’t believe it should be mandatory. We are not really that different from the rest of the world on this issue. Surely the fact there has never been a strong argument or evidence to support helmet legislation by any other country in the world, all of which do not mandate helmets, is reason enough to take a rational look at this legislation.

  • 2
    ggm
    Posted December 20, 2011 at 11:11 am | Permalink

    I’d be interested in the stats on how more marginal helmets could be, and still be epidemiologically measurably useful.

    Smaller, lighter, more gaps, different construction, more or less present on the head/neck..

    Any amount of alternate design might make them foldable, or more portable in other ways and still deliver demonstrable benefit.

    Cycling helmets *used* to be 5 bands of sorbothane rubber and a strap. Did they do any good?

  • 3
    Edward James
    Posted December 20, 2011 at 11:12 am | Permalink

    I have noticed the number of school aged children who do not wear helmets. If I ride my push bike I wear my helmet because I have a license to drive and ride, which I do not want to risk. I notice a lot of competitive mountain bike riders use fair dinkum helmets. Hot and heavy by comparison but more effective in extreme down hill sport. As I have written before if Helmets are such a good thing why are they not compulsory for all road users. Short answer. Politically unpalatable! I have never forgotten the woman I seen who had hit a power pole, not hard. But her head hit the pole through the drivers side window a full on helmet may have saved her. Edward James

  • 4
    Son of foro
    Posted December 20, 2011 at 11:46 am | Permalink

    Do policy makers have to factor in ‘what if’ questions?

    In this case, something along the lines of: What if an increase in people riding bikes without helmets lead to an increase in accidents featuring head trauma or death, the bad publicity / safety fears from which would result in fewer people riding bikes.

    Would we not then be back at square one?

  • 5
    Dave S
    Posted December 20, 2011 at 1:50 pm | Permalink

    I’m going to ignore the following assumptions that the author of this article made as being too ridiculous to take seriously:
    1) That people who said that they had not ridden a bike in the last year but would ride one if helmet laws were repealed would only move up into the “less than once per month” category.
    2) That a person who rides a bike once per year may be considered a cyclist.
    3) That the aim of 2011-2016 National Cycling Strategy is to double the number of people who ride a bicycle at least once per year, rather than to double the number of regular riders, or to double proportion of trips taken by bicycle.

    So that leaves us with the author’s eventual figure that repealing helmet laws would result in an increase in the at-least-in-the-last-month cycling participation rate of “only” 32%.

    My question then, is in what world does the author live, where if aiming for a increase 100% over 5 years, a 32% increase achieved near-instantly with no cost whatsoever is anything less that a incredibly worthwhile venture?

    Yet the author dismisses this enormous gain as inadequate, promoting instead high-cost strategies that are allegedly proven to work, though no actual evidence, nor estimates of gains, are provided. Why not take the free 32% gain, and then (or simultaneously) figure out how to get the remaining 68%?

    As for the question by “Son of foro” in the comments – there is no safety question, as it’s perfectly evident from not only the vast majority of the world, but also within Australia* that areas that do not mandate helmet laws tend to have higher participation rates and better safety records.

    (*The Northern Territory allows cycling without a helmet, and has the highest participation rate in Australia, as well as the lowest injury/fatality rates.)

  • 6
    Luke Turner
    Posted December 21, 2011 at 1:11 am | Permalink

    This is a fairly lightweight criticism of Professor Chris Rissel’s research from Tim Churches. Rissel’s claim that cycling would levels would double with repeal of helmet laws is a rough and ready estimate – but a generally sound one.

    We know for certain that many people would ride more if helmets were optional, but we don’t know whether these people would ride once a year more, or become daily cyclists. But it’s a fairly safe guess that cycling levels would increase by 60-100%. After all, when the laws were introduced, numbers declined by 40% (which if reversed is equivalent to a 67% increase).

    Churches claim that levels would only increase by 17% is complete nonsense and suggests he did not even read Rissel’s paper. People who haven’t ridden in the last year are not the only people who are deterred from riding by helmet laws. 40% of weekly riders, 33% of monthly riders and 24% of yearly riders also said they would ride more if helmets were optional.

    As these figures indicate, compulsory helmets are a significant hindrance to cycling becoming a mainstream and legitimate form of transport. If you are just going to ride your bike once a year in the park for a bit of fun, then the helmet law is probably not going to put you off that trip. But if you want to use a bike as a main or even primary form of transport, perhaps in place of a car, then the unwanted inconvenience of being forced by law to wear a helmet at all times, in all situations, becomes a significant disincentive for many people. I am one of those weekly cyclists who would most definitely ride more if I could choose to leave the helmet at home at times.

    However I completely agree with one thing that Tim Churches says: we need to look at what the European countries have done and emulate that. Better cycling infrastructure and lower speed limits are essential to increase cycling, as is repealing helmet laws. It is not a co-incidence that none of the European countries with high rates of cycling have helmet laws.

  • 7
    SBH
    Posted December 21, 2011 at 2:41 pm | Permalink

    Speaking personally, wearing or not wearing a helmet is not what I think about on a bike. I’m far more worried about innattentive drivers, aggressive drivers, ignorant drivers, bad road surfaces, dickhead cyclists who are a danger to themselves and others, poor road markings, wayward pedestrians, bad attitudes and car doors.

    I have a feeling that many people don’t cycle because its scary and if we addressed the causes of their fear as summarised above, more of them would cycle.

    This debate over helmets just seems misdirected and counter-productive.

  • 8
    Dave
    Posted December 21, 2011 at 4:43 pm | Permalink

    “In order to substantially increase cycling participation and mode-share, and to meet agreed targets, Australian governments and authorities need to focus on strategies which have been proven to work in Europe.”

    If only Tim would take his own advice. No country in Europe has an enforced all age mandatory helmet law. What they do and what has been shown to be very effective is to remove barriers to cycling and reduce the primary danger faced by cyclists: getting hit by a motor vehicle.

    Mandatory helmet laws are a significant (but clearly not the only) barrier to increasing cycling participation. This is especially the case for the type of cycling that has the most beneficial social externalities – utility cycling from A to B that replaces motor transport.

  • 9
    Dave S
    Posted December 21, 2011 at 5:44 pm | Permalink

    SBH – Inattentive, aggressive and ignorant drivers, as well as wayward pedestrians, are all problems that can be solved by getting more cyclists on the roads, thereby forcing other roads users to recognise the legitimacy of cyclists, and forcing them to pay more attention to us. The helmet laws are a barrier to getting more cyclists on the roads.

    Take Denmark as as example. The only pedestrians that ever stray onto their bike paths are tourists: http://satwcomic.com/n00bs-off-the-road

    As for other approaches to solving these problems, would you like to try to calculate the cost of building separated bike paths all over every city in Australia, and running education campaigns for all drivers and pedestrians, perhaps including retesting of drivers with bicycle-specific material in the driving exams, and then compare this cost and the time required to implement it with the time and cost required to revoke mandatory helmet laws? And while you’re at it, perhaps reconsider why you think the two approaches are mutually exclusive, or otherwise how revoking helmet laws could possibly be counter-productive?

  • 10
    Daryl Sadgrove
    Posted December 22, 2011 at 9:08 am | Permalink

    Here are three very powerful stories of why we should develop more cycling infrastructure in Australia.

    http://www.achsm.org.au/Blog.html?year=2011&month=6&ItemID=18&count=1

  • 11
    Family Mazin
    Posted January 21, 2012 at 12:08 pm | Permalink

    Rissel’s style of studies and general approach to research, whereby the conclusion is already made, and the research is done to confirm the views is not useful to so many Australians who want quality infrastructure so that they can cycle safely. People are not SO vain or stupid to think about head fashion or protection before *all other factors* when they want to ride a bike.

    In fact, a lot of people (including me) don’t care if helmets are optional or not, because a lot of people now choose to wear them or not, even at risk of fines – this shows they will ride regardless….which undermines the premise of Rissel’s research which is to blame helmet laws on low ridership.

    Rissel conveniently ignores the multitude of factors that gave rise to a decline in ridership during the 80s and 90s. Yes, the helmet laws came about, but they occurred in a climate of heavy investment in Australian roads and car infrastructure, the general rise in car ownership and individual wealth/status that drove demand for cars, the rise in car brands and visibility and the simultaneous absence of anywhere safe for a regular rider to ride.

    In short, the CONSTANT NOISE given to helmet debates will do nothing to give us the roads and cycleways we, as tax payers, have a right to.

    What Rissel and committed cyclists in this debate should be doing, is raising awareness of the wholesale FAILURE of councils and State governments to deliver us infrastructure that can be shared by riders properly with all other vehicles.

    On a personal level, there are MANY roads where I would not dare to ride in Sydney – helmet or no helmet. They are just too dangerous. Cars are dominant and cyclists are forces to use these roads instead of dedicated cycle roads and cycle highways.

    The helmet debate is a storm in a theoretical tea cup.

  • 12
    Family Mazin
    Posted January 21, 2012 at 12:13 pm | Permalink

    Oh, and anyone that suggests (such as the extremist well know Copenhagen blogger) the ridiculous idea that we must force car drivers to wear helmets too – is purely ignorant. Cars have the equivalent of a helmet: it’s called a mono-coc chassis with airbags and mandatory seat belts. Are the anarchists going to argue for removal of those as well? Maybe it will give us more car drivers if we make seat belts and airbags optional? See, Rissel’s logic doesn’t work…and that’s because there is more to factor in than helmet-use when going for a ride.

    Thank god there is some sanity and intellectual rigour on Crikey unlike so many bike blogs.

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